Notwithstanding Section
51015, when a provider of personal
care services has a grievance or complaint concerning the processing or payment
of money for services rendered, the following procedures must be met:
(a) The provider shall initiate an appeal, by
submitting a grievance or complaint in writing within 90 days of the action
precipitating the grievance or complaint, to the designated county department
identifying the claims involved and specifically describing the disputed action
or inaction regarding such claims.
(b) The designated county department shall
acknowledge the written grievance or complaint within 15 days of its
receipt.
(c) The designated county
department shall review the merits of the grievance or complaint and send a
written decision of its conclusion and reasons to the provider within 30 days
of the acknowledgement of the receipt of the grievance or complaint.
(d) After following this procedure, a
provider who is not satisfied with the decision by the designated county
department may seek appropriate judicial remedies in compliance with Section
14104.5
of the Welfare and Institutions Code, no later than one year after receiving
notice of the decision.
Notes
Cal. Code Regs. Tit. 22, §
51015.2
1. New
section filed 4-14-93 as an emergency; operative 4-14-93. Submitted to OAL for
printing only pursuant to section
8, AB 1773 (Chapter 939, Statutes
of 1992) (Register 93, No. 16).
Note: Authority cited: Section
14132.95,
Welfare and Institutions Code; Section
8, Chapter 939, Statutes of 1922;
Section 3, Chapter 7, Statutes of 1993.
Reference: Section
14132.95,
Welfare and Institutions Code; Section
1396 d(a)(7) of Title 42, of the
United States Code; Article 7 (commencing with Section
12300) of Part 3 of Division 9 of
the Welfare and Institutions Code; Section
440.170(f) of
Title 42 of the Code of Federal
Regulations.
1. New section
filed 4-14-93 as an emergency; operative 4-14-93. Submitted to OAL for printing
only pursuant to section 8, AB 1773 (Chapter 939, Statutes of 1992) (Register
93, No. 16).
